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Medigap Plans CT

Medigap plans Ct are also called Medicare supplement plans. They provides coverage for these “gaps” in your Medicare coverage and can save you money. Medigap plans are not Medicare Advantage plans rather, they provide coverage after Original Medicare A and B benefits pay. As a result, it is important to note that Medigap plans will only cover services that are approved by Medicare. They will not help cover costs that Medicare does not allow/approve.

Medicare supplemental plans are offered by private insurance companies. These plans help to pay the ‘gap’ between costs covered by original Medicare and your out of pocket costs. Medigap plans are regulated by national and state governments and therefore benefits are generally the same, regardless of the insurance company. For example, Plan A has the same benefits regardless of the company you purchase it from. As a result, rates and value add benefits are the only difference from company to company.

We are one of Connecticut’s leading Medicare brokerage firms. Please call us at 203-796-5403 or email us at [email protected] if you have questions. Better yet, we can set a time to sit face to face and discuss all of your options. If you aren’t able to travel to our office, we will gladly come to you.

What is Medicare?

This blog will attempt to answer “what is Medicare?” by providing a basic understanding of the Medicare program and how it works. In addition, it will detail the other parts of Medicare such as C and D. First of all lets start with the official definition: Medicare is the federal health insurance program for people who are 65 or older. It is also for certain younger people with disabilities and with End-Stage Renal Disease. Most people are eligible for Medicare at age 65.

Medicare Part B (Medical Coverage)

Medicare Part C (Medicare Advantage Plans)

A type of Medicare health plan offered by a private insurance company that contracts with Medicare to provide you with all your benefits including Part A, B and D. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans,Special Needs Plans, and Medicare Medical Savings Account Plans (MSA’s). Therefore, if you’re enrolled in a Medicare Advantage Plan, services are covered by the insurance company/plan and not Medicare because Medicare is not the primary insurance. Most Medicare Advantage Plans offer prescription drug coverage.

Medicare Part D (prescription drug coverage)

Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. In addition, Medicare Advantage Plans may also offer prescription drug coverage. They follow the same rules as Medicare Prescription Drug Plans.

What is Medicare: Overall

People often become confused over Medicare. Therefore they confuse Medicare Supplement plans and Medicare Advantage plans with Original Medicare A and B. A Medicare supplement (also called Medigap) is a plan that helps cover the Medical benefits Medicare A and B do not cover entirely. It is secondary to Original Medicare A and B. A Medicare Advantage plan (often called part C) is a plan from a private insurance company. Especially relevant is a person with a Medicare Advantage plan does not use Original Medicare as their insurance. Instead , they use the Advantage plan. As a result, it is not possible to have both plans at the same time.

You have Medicare Eligibility for parts A and B, 3 months prior to the month you are turning 65. You are also eligible the month you turn 65 and up to three months after age 65. If you are 65 or older without A and B can sign up from Jan 1 through March 31st for a July 1 start date. If you are 65 or older and losing health coverage through an employer or through a spouse, you can sign up for A and B. The time frame to sign up is 63 days after losing the coverage. (regardless of the time of year)

Once you enroll in A and B it is time to figure out the best option for your health coverage. There are a number of plans and companies to choose from. As a result, costs range from $0 a month up to about $260 a month for the most expensive options. It is easy to find the right plan type and company but the first step is to sign up for A and B . If you are drawing Social Security, Medicare signs you up automatically. If you are not drawing Social Security, you need to sign up online or through the local Social Security office. I have listed the steps to follow below…

Steps for Medicare eligible people

Step 1- It is easy to sign up for Medicare A and B online. CLICK HERE FOR THE SITE TO SIGN UP FOR MEDICARE A AND B . Please note, your Medicare A and B will start on the first of the month you turn 65. Medicare will charge most people $134 a month for part B. They either bill quarterly or draw it out of your Social Security check. (for those taking Social Security)

Those over the age of 65 can not enroll in A and B online. Please call your local Social Security office to enroll in A and/or B.

Step 2- Some people do not have to pay the $134 monthly premium. If you are single and make less than $2,435.40 or as a couple make less than $3,284.10 you are eligible for a program called Medicare Savings Program (MSP), Enrolling in MSP will provide a number of benefits and you will no longer need to pay the monthly part B premium of $134 a month. CLICK TO LEARN MORE ABOUT MSP (we can help you with the MSP application)

Step 3- The next step is to figure out which type of plan works for you. There is a lot to choose from including Medicare Advantage plans, Medicare supplement plans (also called Medigap) and/or a Medicare Part D drug plan. There are a number of companies offering these plans. Contact our office to see which plan type is best for you. When a chocie is made, our office will help ensure you are enrolled properly. Applications must be sent in prior to the 1st of the month you turn 65 in order to get the appropriate start date.

Notice about the Part D rx penalty

Notice to those signing up for Medicare over age 65: If you are signing up for Medicare A and/or B past the age of 65 please read the following: Medicare charges a penalty (called the Part D Rx penalty) for anyone that was without prescription drug coverage after the age of 65. As a result, if you are signing up for a plan (Medicare Advantage plan or Medicare Part D rx plan) over the age of 65, you will receive a letter stating you need to pay a part D penalty. If you had other drug coverage during that time, you will not need to pay the penalty. Proof of the other coverage will be needed to waive the penalty. The letter you will have instructions about how to appeal. It will take about 2 months for the appeal process. Appeals are processed by a company called Maximus. Please call or email us if you need a generic copy of the appeal form.